N R Pinelli1, C W Nemerovski, T M Koelling. 1. Department of Pharmacy Practice, Wayne State University, Detroit, Michigan 48201, USA. nickipinelli@wayne.edu
Abstract
AIMS: To describe 2.5 years of exposure to sitagliptin on glycemic control, immunosuppressive therapy, and adverse events following solid organ transplantation. CASE REPORT: A 63-year-old Caucasian male received an orthotopic heart transplantation in June of 2006 secondary to idiopathic nonischemic cardiomyopathy. He was diagnosed with new-onset diabetes mellitus after transplantation (NODAT). Sitagliptin monotherapy was initiated in August 2007 and continued for 2.5 years. RESULTS: Hemoglobin A(1c) increased from 5.8% to 6.1%, but the recommended glycemic target of <7% was maintained over time and improvements in fasting home blood glucose monitoring values were achieved. Tacrolimus concentrations were not altered. Only minor dose adjustments to tacrolimus and mycophenolate mofetil were required. Maintenance corticosteroid dose remained unchanged and there was no evidence of biopsy-proven acute rejection. No adverse events were reported. DISCUSSION: This case report demonstrates that long-term sitagliptin treatment for NODAT may be effective, safe, and well tolerated in solid organ transplant recipients.
AIMS: To describe 2.5 years of exposure to sitagliptin on glycemic control, immunosuppressive therapy, and adverse events following solid organ transplantation. CASE REPORT: A 63-year-old Caucasian male received an orthotopic heart transplantation in June of 2006 secondary to idiopathic nonischemic cardiomyopathy. He was diagnosed with new-onset diabetes mellitus after transplantation (NODAT). Sitagliptin monotherapy was initiated in August 2007 and continued for 2.5 years. RESULTS: Hemoglobin A(1c) increased from 5.8% to 6.1%, but the recommended glycemic target of <7% was maintained over time and improvements in fasting home blood glucose monitoring values were achieved. Tacrolimus concentrations were not altered. Only minor dose adjustments to tacrolimus and mycophenolate mofetil were required. Maintenance corticosteroid dose remained unchanged and there was no evidence of biopsy-proven acute rejection. No adverse events were reported. DISCUSSION: This case report demonstrates that long-term sitagliptin treatment for NODAT may be effective, safe, and well tolerated in solid organ transplant recipients.
Authors: Ibrahim Gueler; Susanne Mueller; Matthias Helmschrott; Christian U Oeing; Christian Erbel; Lutz Frankenstein; Christian Gleißner; Arjang Ruhparwar; Philipp Ehlermann; Thomas J Dengler; Hugo A Katus; Andreas O Doesch Journal: Drug Des Devel Ther Date: 2013-04-08 Impact factor: 4.162